The American journal of the medical sciences
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Randomized Controlled Trial
Trimetazidine Prevention of Contrast-Induced Nephropathy in Coronary Angiography.
Contrast-induced nephropathy (CIN) after coronary angiography is frequently observed in patients with chronic renal insufficiency and no effective measures have been developed for prevention of CIN. There is evidence showing that trimetazidine (TMZ) has renoprotective effect on CIN. This study was to evaluate the role of TMZ in the prevention of CIN in renal dysfunction patients undergoing coronary angiography. ⋯ TMZ in combination with standard hydration is more effective than isotonic saline alone in protecting renal function in patients with renal dysfunction who undergo coronary angiography and can reduce the adverse events within 12 months.
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Randomized Controlled Trial
A Pilot Study to Determine if Vitamin D Repletion Improves Endothelial Function in Lupus Patients.
The endothelium is important not only in regulating vascular tone but also in modulating inflammation. Patients with systemic lupus erythematosus (SLE) have deficits in these endothelial functions. Vitamin D is a nuclear hormone that regulates vascular endothelial nitric oxide synthase activity and expression. Many SLE patients have insufficient levels of vitamin D. The effect of this hormone on vascular endothelial function in SLE patients is not known. This study was designed to determine the effect size of repleting vitamin D levels on endothelial function in patients with SLE and vitamin D deficiency. ⋯ These results suggest a potential role for vitamin D in SLE-related endothelial dysfunction and that an adaptive, multi-arm, treat-to-target, serum-level trial design may increase the efficiency and likelihood of success of such a study.
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Randomized Controlled Trial Multicenter Study
A multicenter, randomized, trial comparing urapidil and nitroglycerin in multifactor heart failure in the elderly.
Multifactor heart failure is a common life-threatening event in elderly patients and often complicated by concomitant hypertension and diabetes mellitus (DM). The aim of this study was to evaluate whether α1-blocker, urapidil, provides additional therapeutic benefits compared to nitroglycerin (NG) in treatment of multifactor heart failure complicated by hypertension and DM in elderly patients. ⋯ Urapidil demonstrated better efficacy than NG on lowering and stabilizing systolic BP, attenuating cardiac afterload and improving cardiac function. Both NG and urapidil significantly reduced FPG levels in multifactor heart failure patients with DM. Urapidil is a therapeutic option for the multifactor heart failure patients complicated with hypertension and DM.
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Randomized Controlled Trial
Concurrent Neoadjuvant Chemoradiotherapy for Siewert II and III Adenocarcinoma at Gastroesophageal Junction.
This study was conducted to investigate the efficacy and safety of using a concurrent neoadjuvant chemoradiotherapy (a XELOX regimen) to treat adenocarcinoma of the gastroesophageal junction. ⋯ Concurrent neoadjuvant chemoradiotherapy administration increased the rate of R0 resection and demonstrated favorable safety in patients with Siewert II or III adenocarcinoma at the gastroesophageal junction. These results support the use of neoadjunctive chemoradiotherapy in the treatment of adenocarcinoma of the gastroesophageal junction.
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Randomized Controlled Trial
A web-based cultural competency training for medical students: a randomized trial.
The objectives of this research were to compare a Web-based curriculum with a traditional lecture format on medical students' cultural competency attitudes using a standardized instrument and to examine the internal consistency of the standardized instrument. ⋯ A Web-based and a lecture-based cultural competency training strategies were associated with equally high positive attitudes among 1st-year medical students. These findings warrant further evaluation of Web-based cultural competency educational interventions.